Berk is a New York City writer in his 60s wrestling with loneliness and the contemplation of his own mortality. He is romantically involved with a 26 year-old graduate student. He is asked by his employer to investigate the mysterious death of his cousin, a psychiatrist who burst into flames on an operating table during the ligation of a colonic polyp. The cover conveys the medical tragedy. Along the way he decides to write a novel about one of the psychiatrist's patients. This clever, well-written novel is filled with intrigue, twists and interesting characters. Although I could not relate to any of the characters, I still enjoyed the story. The story within a story that Berk is writing slowly converges with reality. This is not going to work for readers who are squeamish or prudish; there are detailed medical descriptions and BDSM sex. Others who enjoy a good thought-provoking mystery will like this book.